'plan'

I have been in this country for a year now and I still find some things to be difficult, or more difficult then would otherwise be in Australia.

For as hard as I have tried, the health insurance structure/benefits/costs here in the States baffle’s me more now then they did 12 months ago. There is a part of me that would argue, with a very strong case mind you, that knowing nothing about the medical system would in fact give me a better perspective of how it all works.

Ever since I started ‘partying’ with non-prescription medication about 5-6 years ago I have had trouble breathing; and it has gotten worse. I figured my poor life style had in some way affected my lungs, heart or some other life sustaining component of my body resulting in shortness of breathe, mini heart attacks and tightness of the chest.

Moving overseas was probably the best thing for my health, I guess. I stopped, or more appropriately, slowed down my partying ways and concentrated more on establishing myself in a full-time position with a land development firm. It has been hard not having my friends and living a lifestyle that not many people get to live in their life so I am forever grateful for those years.

I feel healthier now then I ever have but my breathing seems to be deteriorating and because of that I finally had my partner in crime and girlfriend, Louie (who I shall so affectionately name for blog security purposes) book me in to see a doctor.

Now you may ask why I couldn’t do it myself. Well, this is where the intricacies of the unpopular USA health system come to light.

See, in order to visit a doctor, it is imperative that you first check with your soon to be GP and see if they are covered by the particular insurer that you have chosen from your employer (and that in itself is problematic due to the sheer number of options to choose from). Once you have found a physician who is sponsored through your insurer you can then expect to wait 3-4 weeks to get in for a visit.

After much discussion about my family history and past indulgences I gladly paid the copay of $35 and went on my way, happy to have finally done something about my persisting problem. Three weeks later and after losing my prescription twice and almost throwing it away I went to the pharmacy to fix my broken body. Twenty minutes, thirty minutes goes by and finally the pharmacist tells me there is no record of me in any health insurance what so ever??

Instead of paying $7.76 for my prescription I am now being stung with an incredibly high $158.12. How on earth it can go from $7.76 to $158.12 is beyond me! After walking out of the pharmacy $160 poorer, a slight emotion came over me to pinch something to make up for iron-fisted pharmacist for not ‘hooking me up’, but thinking better of it I choose to walk out with with the little dignity I had left. Would me theiving an extra chocolate bar really make it all worth it? No.

Once I got home, checked the mail and noticed I had received a letter from the hospital I visitied weeks earlier, I quickly unwrapped it in hope that there was some inexplicable mistake regarding my health insurance and I would be able to recover my burnt $160. But instead I was presented with yet another cost to incur…The cost of my doctors visit!

As I have come to learn, until I have spent $1000 of my own money on my health, only then can I claim a rebate for ANYTHING. It seems I picked a plan that is better suited for those who suffer through many broken bones and viruses throughout the course of a year because once that $1000 threshold has passed, anything and everything is free from there on out.

Needless to say I have now changed my ‘plan’ to allow myself free coverage up to a certain threshold which I am certain I will not reach, although, my luck I will probably have every injury imaginable this year and wishing I had stayed the course of my previous plan.